背景:肺癌(LC),其特点是发病率和死亡率高,在肿瘤学中提出了重大挑战。尽管在治疗方面取得了进展,早期检测对于改善患者预后仍然至关重要.通过检测呼出气中的挥发性有机化合物(VOC)来筛选LC的准确性尚待确定。
方法:我们的系统评价,遵循PRISMA指南并分析截至2023年10月1日的25项研究的数据,评估不同技术检测VOCs的有效性。我们向PROSPERO注册了审查方案,并在PubMed中进行了系统搜索,EMBASE和WebofScience。审稿人筛选了研究的标题/摘要和全文,并使用QUADAS-2工具进行质量评估。然后通过采用敏感性和特异性的双变量模型进行荟萃分析。
结果:本研究探讨了呼出气体中挥发性有机化合物作为LC筛查生物标志物的潜力,提供传统方法的非侵入性替代方案。在所有研究中,呼出的VOCs将LC与对照区分开。荟萃分析表明,综合敏感性和特异性分别为85%和86%,分别,VOC检测的AUC为0.93。我们还对测试化合物中出现频率最高的物质来源进行了系统分析。尽管结果很有希望,研究质量和方法学挑战的可变性凸显了进一步研究的必要性。
结论:这篇综述强调了VOC分析的潜力,早期LC检测的非侵入性筛查工具,这可以显著提高患者管理和生存率。
BACKGROUND: Lung cancer (LC), characterized by high incidence and mortality rates, presents a significant challenge in oncology. Despite advancements in treatments, early detection remains crucial for improving patient outcomes. The accuracy of screening for LC by detecting volatile organic compounds (VOCs) in exhaled breath remains to be determined.
METHODS: Our systematic review, following PRISMA guidelines and analyzing data from 25 studies up to October 1, 2023, evaluates the effectiveness of different techniques in detecting VOCs. We registered the review protocol with PROSPERO and performed a systematic search in PubMed, EMBASE and Web of Science. Reviewers screened the studies\' titles/abstracts and full texts, and used QUADAS-2 tool for quality assessment. Then performed meta-analysis by adopting a bivariate model for sensitivity and specificity.
RESULTS: This study explores the potential of VOCs in exhaled breath as biomarkers for LC screening, offering a non-invasive alternative to traditional methods. In all studies, exhaled VOCs discriminated LC from controls. The meta-analysis indicates an integrated sensitivity and specificity of 85% and 86%, respectively, with an AUC of 0.93 for VOC detection. We also conducted a systematic analysis of the source of the substance with the highest frequency of occurrence in the tested compounds. Despite the promising results, variability in study quality and methodological challenges highlight the need for further research.
CONCLUSIONS: This review emphasizes the potential of VOC analysis as a cost-effective, non-invasive screening tool for early LC detection, which could significantly improve patient management and survival rates.